BELC2015-0088,,. !f
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78-495 CALLE TAMPICC O
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VOICE (760) 777-7125
LA QUINTA, CALIFORNIA 92253 COMMUNITY DEVELOPMENT DEPARTMENT
FAX (760) 777-7011
INSPECTIONS (760) 777-7153
BUILDING PERMIT
Date: 9/15/2015
Application Number:
BELC2015-0088
Owner:
Property Address:
80125 VIA CAPRI
MARIE DURFLINGER
APN:
777100062
219 SW 298TH PL
vin �1
Application Description:
HIDEAWAY/ (1)TEMP POLE
FEDERAL WAY, WA 0
Property Zoning:
Application Valuation:
$200.00''
a c�
Applicant:
Contractor:
MONARCH HOMES
'MONARCH HOMES
49950 JEFFERSON STREET
#130
49950 JEFFERSON STREET #130
LA QUINTA, CA 92264
LA QUINTA, CA 92264
m
(951)634-6381
Llc. No.: C28860
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter
9 (commencing with Section 7000) of Division 3 of the ss and Professions Code,
and my License is in full force and effect.
License Class: License No.: C28860
DaAe l�t 'S t Contractor:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State
License Law for the following reason (Sec. 7031.5, Business and Professions Code: Any
city or county that requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for the permit to file a
signed statement that he or she is licensed pursuant to the provisions of the
Contractor's State License Law (Chapter 9 (commencing with Section 7000) of Division
of the Business and Professions Code) or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a
permit subjects the applicant to a civil penalty of not more than five hundred dollars
($500).:
( ) I, as owner of the property, or my employees with wages as their sole
compensation, will do the work, and the structure is not intended or offered for sale.
(Sec. 7044, Business and Professions Code: The Contractors' State License Law does not
apply to an owner of property who builds or improves thereon, and who does the work
himself or herself through his or her own employees, provided that the improvements
are not intended or offered for sale. If, however, the building or improvement is sold
within one year of completion, the owner -builder will have the burden of proving that
he or she did not build or improve for the purpose of sale.).
I ) I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project. (Sec. 7044, Business and Professions Code: The Contractors'
State License Law does not apply to an owner of property who builds or improves
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to
the Contractors' State License Law.).
(_) I am exempt under Sec. . B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for
the performance of the work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by Section 3700 of the Labor Code, for the performance
of thrk for which this permit is issued.
I have and will maintain workers' compensation insurance, as required by
Section 3700 of the Labor Code, for the performance of the work for which this permit
is issued. My workers' compensation insurance carrier and policy number are:
Carrier:_ Policy Number:
I certify that in the performance of the work for which this permit is issued, I
shall not employ any person in any manner so as to become subject to the workers'
compensation laws of California, and agree that, if I sho eco= subject to the
workers' compensation provisions of Section 3700 of the de, I shall forthwith
comply with those provisions.
Da Applicant:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN.EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO
ONE HUNDRED THOUSAND DOLLARS ($100,000). IN ADDITION TO THE COST OF
COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,
INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT: Application is hereby made to the Building Official for a permit subject to
the conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose
request and for whose benefit work is performed under or pursuant to any permit
issued as a result of this application , the owner, and the applicant, each agrees to, and
shall defend, indemnify and hold harmless the City of La Quinta, its officers, agents, and
employees for any act or omission related to the work being performed under or
following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is
not commenced within 180 days from date of issuance of such permit, or cessation of
work for 180 days will subject permit to cancellation.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and sta to building
construction, and hereby authorize representatives of this 6711tuWn the above-
mentioned property -for inspection purposes.
r r �
Date? - �t Signature (Applicant or Agent)
FINANCIAL • '
y ` DESCRIPTION ` I. ACCOUNT,QTY
+
AMOUNT' �-Y F ` s " PAID PAID DATE
BSAS SB1473 FEE 101-0000-20306
0 $1.00 $0.00
" PAID BY"METHOD."'-
is
RECEIPT # CHECK # , CLT D BY
Total Paid forBUILDING STANDARDS ADMINISTRATION BSA $1.00 $0.00
DESCRIPTION•ACCOUNT
QTY
AMOUNT
PAID
PAID DATE
TEMP POWER SERVICE
101-0000-42403
0
$24.17
$0.00
. PAID BY ` ` a
` w> METHOD .'
RECEIPT # *
CHECK # J. w:
CLTD BYE`
DESCRIPTION = _ Y,
., ACCOUNT
QTY :
^ AMOUNT,`'`,
PAID
PAID DATE
TEMP POWER SERVICE PC
101-0000-42600
0
$16.92
$0.00
PAID BY,
METHOD
RECEIPT #
CHECK #
;CLTD BY
Total Paid forELECTRICAL: $41.09 $0.00
DESCRIPTION `F} +
`' ACCOUNT _
QTY
" • ;AMOUNT
PAID
PAID DATE
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
-" �:' - , _
PAID. BY
ME
METHOD ,'
RECEIPT4_ s
CHECK # ;-
CLTD BY
Total Paid forPERMIT ISSUANCE: $91.85 $0.00
• + 00
Description: HIDEAWAY / (1)TEMP POLE
Type: ELECTRICAL
Subtype: Siaius: UNDER REVIEW
Applied: 9/15/2015 SKH
Approved:
Parcel No: 777100062 Site Address: 80125 VIA CAPRI LA QUINTA,CA 92253
Subdivision: TR 29894-2
Block: Lot: 33
Issued:
Lot Scl Ft: 0
Building Scl Ft: 0 Zoning:
Finaled:
Valuation: $200.00
Occupancy Type: Construction Type:
Expired:
No. Buildings: 0
No. Stories: 0 No. Unites: 0
ZIP PHONE - FAX -: EMAIL--.: -
Details: ELECTRICAL- (1) TEMP POLE. 2013 CALIFORNIA BUILDING CODES.
MONARCH HOMES
..
AnnlTl(aNAI„ SITES
FINANCIAL INFORMATION
Printed: Tuesday, September 15, 2015 10:15:26 AM 1 of 2
SYS7fiAAS
''CONS
•
CONTACTS
NAME TYPE
NAME,> f`
^ADDRESSl`
CITY
STATE.
ZIP PHONE - FAX -: EMAIL--.: -
APPLICANT
MONARCH HOMES
49950 JEFFERSON
LA QUINTA
CA
92264
STREET #130
CONTRACTOR
MONARCH HOMES .
49950 JEFFERSON
LA QUINTA
CA
92264
STREET #130
OWNER
MARIE DURFLINGER
219 SW 298TH PL
FEDERAL WAY
WA
0
FINANCIAL INFORMATION
Printed: Tuesday, September 15, 2015 10:15:26 AM 1 of 2
SYS7fiAAS
INSPECTIONS
SEQID' INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
ELECTRICAL FINAL" BLD
CLTy7
DESCRIPTION
ACCOUNT
QTY '
AMOUNT
PAID
PAID DATE
.
RECEIPT #
CHECK #
METHOD
PAID BY
. BY
BSAS SB1473 FEE
101-0000-20306
0
$1.00
$0.00
Total Paid forBU1LDING STANDARDS ADMINISTRATION $1.00 $0.00
BSA:
TEMP POWER SERVICE
101-0000-42403
0
$24.17
$0.00
TEMP POWER SERVICE
101-0000-42600
0
$16.92
$0.00
PC
Total Paid forELECTRICAL: $41.09 $0.00
PERMIT ISSUANCE
101-0000-42404
0
$91.85
$0.00
Total Paid for PERMIT ISSUANCE: $91.85 $0.00
TOTALS:7. 0'0
INSPECTIONS
SEQID' INSPECTION TYPE INSPECTOR SCHEDULED COMPLETED
DATE DATE
RESULT REMARKS NOTES
ELECTRICAL FINAL" BLD
BOND INFORMATION
ATTACHMENT$
Printed: Tuesday, September 15, 2015 10:15:26 AM 2 of 2 C
SYSTEMS
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_AVE. 52
JOB'
SITE
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VIA CAPRI
VICINITY MAP
__......_____. _ �f
WIRE & CND NOTES:
S
I I
/—'\ CUSTOMER IN: 1-2 PVC SCHEDULE 40 SERVICE CONDUIT, 10 R -R
t IID IN: 1/O ALUM. TRIPLEX,1201240V, 1 e (20') �'' �N
h / 1ooA
OF LA / 120/240VBTIBUILDING & CUIN�� /
APP'ROVETY DEPT.
FOR TION
DATE L_(f �
NOTE TO CUSTOMER: .
PLEASE CONTACT IID INSPECTOR PRIOR
TO UNDERMINING ENERGIZE STRUCTURE.
760-398-5828
PLEASE HAVE ADDRESS AND SERVICE
NOTIFICATION NUMBER AT HAND.
w1
IMPERIAL IRRIGATION DISTRICT
N
-1 inch = 100 feet
MONARCH HOMES
80125 VIA CAPRI
LA QUINTA, CA 92253
SERVICE LAYOUT
SERVICE NOTIFICATIONA019305 I SERVICE ORDER:60097919 I DRAWN BY: ASANDOVAL I DATE: 05/18/2015
Bi" • �„
v
City of La Quinta
Building a Safety Division
78-495 Calle Tampico
La Quinta, CA 92253 - (760) 777-7012
Building Permit Application and Tracking Sheet
Permit #
Project Address: �j 0'- � /L /
Owner's Name:
A. P. Number:
Address:
Legal Description:
City, ST, Zip:
Contractor: /J S
0 e
Telephone:
...............
Address: 6-0 Te-rf SCh, f04 Yr, 01519
Project Description:
City, ST, Zip: l0 -9-22-0114
F
C'Yh W E'�... o �
TeleP ho n •
e. oS1. 3 �o 3
1
State Lie. # :
City Lie. #..
Arch., Engr., Designer:
Address:
City., ST, Zip:
Telephone:
.:
Construction Type: Occupancy:
YP P Y
State Lie. #•
ProJect hPa (circle one): New Add'n Alter Repair Demo
Name of Contact Person: ZW'O
Sq. Ft.:
# Stories:
# Units:
Telephone # of Contact Person: Sl `� - to 391
Estimated Value of Project:
APPLICANT: DO NOT WRITE BELOW THIS LINE
#
Submittal
Req'd
Recd
TRACKING
PERMIT FEES
Plan Sets
Plan Check submitted
Item
Amount
Structural Cates.
Reviewed, ready for. corrections
Plan Check Deposit
Truss Cafes.
Called Contact Person
Plan Check Balance
Title 24 Cales.
Plans picked up
Construction
Flood plain plan
Plans resubmitted
Mechanical
Grading plan
2nd Revicw,:ready for-corrections/issue
Electrical
Subcontactor List
Called Contact Person
Plumbing
Grant Decd
Plans picked up
S.M.I.
II.O.A. Approval
Plans resubmitted
Grading
IN HOUSE:-
'"! Review, ready for corrections/issue
Developer Impact Fee
Planning Approval
Called Contact Person
A.I.P.P.
Pub. Wks. Appr
Date of permit issue
School Fees,
Total Permit Fees